Reported cases of enteric fever in England and Wales have been increasing in recent years, see table and reports below. To better understand the epidemiology of both travel-associated and non-travel-associated enteric fever and to assess its impact on the UK more accurately, an active national surveillance scheme for enteric fever in England, Wales and Northern Ireland was introduced on 1 May 2006, managed by the Travel and Migrant Health Section (TMHS) at Colindale. Data collected through this scheme has contributed to the evidence base for pre-travel advice by identifying particular population subgroups at risk and the new Public Health Operational Guidelines for Typhoid and Paratyphoid (Enteric Fever).
The protocol and questionnaire were originally developed by a multidisciplinary collaborative steering group drawn from specialists and practitioners based in Health Protection Services, Local Authorities Coordinators of Regulatory Services and the National Travel Health Network and Centre [external link]. The questionnaire was updated for 2011 in the light of analysis of 2007-2010 data both to improve the clarity of the questions and to include a change in the definition of a travel-associated case of enteric fever from three weeks to one month post travel. The Typhoid and Paratyphoid Reference Group, which has been responsible for the development of the new public health operational guidelines (above), has now requested some further amendments to the form in order to help guide local investigation into the source of infection for cases that are not travel-associated (section 7), and to record microbiological clearance for cases.
As of 1 Feb 2012, health protection practitioners and environmental health officers are requested to use the national questionnaire below for reporting all cases of enteric fever to the national surveillance system. The questionnaire should be returned as previously to TMHS@phe.gov.uk (or uploaded to HPZone with notification of this upload to TMHS) . Those returning the forms are asked to try to ensure that all fields are completed, but not to delay return pending the results of local investigations of non-travel associated infections if these investigations are likely to be prolonged. Where necessary, section 7 of the form can be re-sent at a later date when complete. Please note that the new section on microbiological clearance is being collected by TMHS on behalf of local colleagues who will be evaluating the new operational guidelines; these fields will not be included in the national database. Similarly, as previously, none of the fields listing details of contacts of cases are entered into the national surveillance database.For any questions about enhanced surveillance of enteric fevers please contact the Travel and Migrant Health Section (TMHS@phe.gov.uk).
For any questions about the public health operational guidelines for enteric fever please contact the chair of the Typhoid and Paratyphoid Reference Group, Dr Sooria Balasegaram (Sooria.Balasegaram@phe.gov.uk).
Enhanced surveillance of enteric fever questionnaire (Word Document, 271 KB) (97-2003 version) updated 30/04/2013
Last reviewed: 6 September 2013